In my case, the adenoma showed up on the nuclear scan. So they knew there was one minimum. When they checked the PTH at 15 minutes after it was removed and 30 minutes, it kept dropping so there was a high chance that there was only one. Some surgeons will look at all 4 to see if there are others that didn't show on the scan. The risk with that is causing unnecessary scar tissue. There are 2 schools of thought and I trusted my surgeon that he thought it was best to only check the one that showed on the scan. There are instances when they don't show up and then they operate and "go fishing".

If your calcium is high and your PTH is high, there is only one cause. Hyperparathyroidism. There is only one cure, surgery. There are no medications that will make you better. None.

When I talked to the Endo at Mayo, I expressed my frustration with my PCP at not catching it for many years. He said it is a common belief for PCPs to want to wait for the calcium to go higher. With hyperparathyroidism, there is no "higher". For women above 55, anything above 10.0 is considered high. The labs most times will have a 8.5 - 10.3 reference range. For sure, anything above the reference range is "High" and you need to have your PTH and Calcium tested in the same blood draw. That is also very important. In a 3 month period, my calcium ranged from 9.9 - 11.3.

When you have the adenoma removed, you are cured. You no longer have hyperparathyroidism. I felt SO bad before the surgery. I lost 40 pounds, I had no appetite, nausea, brain fog, extreme bone pain, was tired, thirsty, frequent urination, hair loss, really cranky, anxious, the symptoms just go on and on. My husband noticed a difference when I came up from the recovery room. I ate a full supper that night and it tasted good. I was back on the treadmill 4 days later and walked several miles. I was the energizer bunny.

My recommendation for others is to watch their calcium. If it is high, above 10, ask for the PTH and calcium to be tested in the same draw. Don't wait. They may want to check the Vit D. My PCP wanted to check that and have me on Vit D supplements if needed. When my Vit D was tested at Mayo, it was normal so that wasn't a factor. I did change to a younger PCP and he is very knowledgeable about this. Other younger doctors that I have encountered have been also. So I think the medical schools are doing a better job in educating their students. Hyperparathyroidism is actually pretty common and very much undiagnosed.

I have done tons of research on this. I am by no means an expert, but I have lived through the experience and am on the "Other side". Please ask any questions and I will do my best to answer them. Mayo Clinic does a very good job with their online explanation of it. It was the first place I looked at when I had my initial diagnosis.